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[DOI] [PMC free article] [PubMed] [Google Scholar] 176.Vieira, V

Mechanism of Action of IGF-1 LR3 IGF-1 LR3 binds to the IGF-1 receptor (IGF1R) , activating intracellular pathways such as: PI3K/Akt/mTOR pathway Drives protein synthesis and muscle growth MAPK pathway Influences cell proliferation and differentiation Key effects include: Stimulating muscle stem cells (satellite cells) Increasing nitrogen retention in muscle tissue Enhancing glucose uptake for energy and glycogen replenishment Promoting connective tissue healing 6

Such diversity in origin challenges the traditional hierarchical model of tumorigenesis and necessitates a more flexible framework that integrates both differentiationstate plasticity and clonal evolution

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